Defect Area Research Articles

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

Multitudinous advancements have been made to the traditional microfracture (MFx) technique, which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage defect. The relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely understood. To comparatively analyze the functional, radiological, and histological outcomes, and complications of various generations of MFx available for the treatment of cartilage defects. A systematic review was performed using PubMed, EMBASE, Web of Science, Cochrane, and Scopus. Patients of any age and sex with cartilage defects undergoing any form of MFx were considered for analysis. We included only randomized controlled trials (RCTs) reporting functional, radiological, histological outcomes or complications of various generations of MFx for the management of cartilage defects. Network meta-analysis (NMA) was conducted in Stata and Cochrane's Confidence in NMA approach was utilized for appraisal of evidence. Forty-four RCTs were included in the analysis with patients of mean age of 39.40 (± 9.46) years. Upon comparing the results of the other generations with MFX-I as a constant comparator, we noted a trend towards better pain control and functional outcome (KOOS, IKDC, and Cincinnati scores) at the end of 1-, 2-, and 5-year time points with MFx-III, although the differences were not statistically significant (P > 0.05). We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture (weighted mean difference: 17.44, 95% confidence interval: 0.72, 34.16, P = 0.025; without significant heterogeneity) at 1 year. However, the difference was not maintained at 2 years. There was a trend towards better defect filling on MRI with the second and third generation MFx, although the difference was not statistically significant (P > 0.05). The higher generations of traditional MFx technique utilizing acellular and cellular components to augment its potential in the management of cartilage defects has shown only marginal improvement in the clinical and radiological outcomes.

In Vivo Evaluation of Regenerative Osteogenic Potential Using a Human Demineralized Dentin Matrix for Dental Application.

The use of a demineralized dentin matrix (DDM) has garnered substantial importance in dentistry. This study was carried out to evaluate the osteoinductive performance of DDM in comparison to nano-hydroxyapatite (n-HA) on calvarial critical-sized bone defect. Two critical-sized defects (CSDs) were bilaterally trephined in the calvarium of sixteen healthy white rabbits. The rabbits were categorized into four groups: in group 1, the defect was left empty; in group 2, defects were filled with sodium alginate (SA) hydrogel as a sole material; in group 3, defects were treated with nano-hydroxyapatite hydrogel (NHH); in group 4, defects were treated using demineralized dentin matrix hydrogel (DDMH). Histological and immunohistochemical analyses were carried out to evaluate the total areas of newly formed bone. The DDMH group showed that new woven bone tissue progressively bridged the defect area while there was no bone in the control group. Collagen expression was significantly different in the DDMH- and NHH-treated groups compared to in the SA group at 4 and 8 weeks (p < 0.01). OCN expression was significantly higher in the DDMH group in comparison to in the NHH or SA groups at 8 weeks (p < 0.01). The DDMH group exhibited significantly higher levels of new bone formation compared to the NHH group at both 4 and 8 weeks post-surgically.

A Deep Learning Approach for Surface Crack Classification and Segmentation in Unmanned Aerial Vehicle Assisted Infrastructure Inspections.

Surface crack detection is an integral part of infrastructure health surveys. This work presents a transformative shift towards rapid and reliable data collection capabilities, dramatically reducing the time spent on inspecting infrastructures. Two unmanned aerial vehicles (UAVs) were deployed, enabling the capturing of images simultaneously for efficient coverage of the structure. The suggested drone hardware is especially suitable for the inspection of infrastructure with confined spaces that UAVs with a broader footprint are incapable of accessing due to a lack of safe access or positioning data. The collected image data were analyzed using a binary classification convolutional neural network (CNN), effectively filtering out images containing cracks. A comparison of state-of-the-art CNN architectures against a novel CNN layout "CrackClassCNN" was investigated to obtain the optimal layout for classification. A Segment Anything Model (SAM) was employed to segment defect areas, and its performance was benchmarked against manually annotated images. The suggested "CrackClassCNN" achieved an accuracy rate of 95.02%, and the SAM segmentation process yielded a mean Intersection over Union (IoU) score of 0.778 and an F1 score of 0.735. It was concluded that the selected UAV platform, the communication network, and the suggested processing techniques were highly effective in surface crack detection.

A new method for deep learning detection of defects in X-ray images of pressure vessel welds.

Given that defect detection in weld X-ray images is a critical aspect of pressure vessel manufacturing and inspection, accurate differentiation of the type, distribution, number, and area of defects in the images serves as the foundation for judging weld quality, and the segmentation method of defects in digital X-ray images is the core technology for differentiating defects. Based on the publicly available weld seam dataset GDX-ray, this paper proposes a complete technique for fault segmentation in X-ray pictures of pressure vessel welds. The key works are as follows: (1) To address the problem of a lack of defect samples and imbalanced distribution inside GDX-ray, a DA-DCGAN based on a two-channel attention mechanism is devised to increase sample data. (2) A convolutional block attention mechanism is incorporated into the coding layer to boost the accuracy of small-scale defect identification. The proposed MAU-Net defect semantic segmentation network uses multi-scale even convolution to enhance large-scale features. The proposed method can mask electrostatic interference and non-defect-class parts in the actual weld X-ray images, achieve an average segmentation accuracy of 84.75% for the GDX-ray dataset, segment and accurately rate the valid defects with a correct rating rate of 95%, and thus realize practical value in engineering.

Maxillary bone healing and CT value after Le Fort I osteotomy using absorbable plate system: A retrospective study

This study aimed to evaluate maxillary bone healing and computed tomography (CT) values after Le Fort I osteotomy with sagittal split ramus osteotomy in patients with class II and III malocclusion. Four absorbable plates and screws were used to fix the maxillary segments in all patients. For 112 sides (58 patients), the bone defect areas at the anterior and posterior sites between the maxillary segments were measured using 3-dimensional CT views reconstructed over a constant CT value at 1 week and 1 year postoperatively. Subsequently, CT values at the upper, middle, and lower sites around the osteotomy line in the medial, middle, and lateral regions were measured. The bone defect area after 1 year increased at the anterior site in class III and at both the anterior and posterior sites in class II (P < 0.05). This study suggests that the increase in bone defect area was affected by lower CT values at the middle site of the middle and lateral regions in class II, and that bony defects between fragments in the maxilla could partially remain in both classes II and III within 1 year after Le Fort I osteotomy.

A photoresponsive recombinant human amelogenin-loaded hyaluronic acid hydrogel promotes bone regeneration.

In order to evaluate the effect of methacrylated hyaluronic acid (HAMA) hydrogels containing the recombinant human amelogenin (rhAm) invitro and invivo. The ultimate goal in treating periodontal disease is to control inflammation and achieve regeneration of periodontal tissues. In recent years, methacrylated hyaluronic acid (HAMA) containing recombinant human amyloid protein (rhAm) has been widely used as a new type of biomaterial in tissue engineering and regenerative medicine. However, there is a lack of comprehensive research on the periodontal regeneration effects of this hydrogel. This experiment aims to explore the application of photoresponsive recombinant human amelogenin-loaded hyaluronic acid hydrogel for periodontal tissue regeneration and provide valuable insights into its potential use in this field. The effects of rhAm-HAMA hydrogel on the proliferation of human periodontal ligament cells (hPDLCs) were assessed using the CCK-8 kit. The osteogenic differentiation of hPDLCs was evaluated through ALP staining and real-time PCR. Calvarial parietal defects were created in 4-week-old Sprague Dawley rats and implanted with deproteinized bovine bone matrix in different treatment groups. The animals were euthanized after 4 and 8 weeks of healing. The bone volume of the defect was observed by micro-CT and histological analysis. Stimulating hPDLCs with rhAm-HAMA hydrogel did not significantly affect their proliferation (p > .05). ALP staining and real-time PCR results demonstrated that the rhAm-HAMA group exhibited a significant upregulation of osteoclastic gene expression (p < .05). Micro-CT results revealed a significant increase in mineralized tissue volume fraction (MTV/TV%), trabecular bone number (Tb.N), and mineralized tissue density (MTD) of the bone defect area in the rhAm-HAMA group compared to the other groups (p < .05). The results of hematoxylin and eosin staining and Masson staining at 8 weeks post-surgery further supported the results of the micro-CT. The results of this study indicate that rhAm-HAMA hydrogel could effectively promote the osteogenic differentiation of hPDLCs and stabilize bone substitutes in the defects that enhance the bone regeneration invivo.

Comparison of the Cathodic Protection of Epoxy Resin Coating/Zinc-Rich Coatings on Defective Areas under Atmospheric and Immersion Conditions: The Secondary Activation of Zinc Particles

The cathodic protection provided by epoxy coating/epoxy zinc-rich coatings on defective areas under atmospheric and immersion conditions was studied via a Q235 wire beam electrode (WBE), scanning electron microscopy, X-ray diffraction, and surface morphology analysis. The results showed that the cathodic protection processes under the two test conditions displayed significant differences. The effective protection time of the defective area under the atmospheric condition was 1.7 times that under the immersion condition. Compared with the immersion condition, zinc particles in zinc-rich coatings under the atmospheric condition exhibited higher cathodic protection efficiency. The possible activation mechanism of zinc particles under the two conditions was elucidated.

Three-Dimensional Virtual Reconstruction of External Nasal Defects Based on Facial Mesh Generation Network.

(1) Background: In digital-technology-assisted nasal defect reconstruction methods, a crucial step involves utilizing computer-aided design to virtually reconstruct the nasal defect's complete morphology. However, current digital methods for virtual nasal defect reconstruction have yet to achieve efficient, precise, and personalized outcomes. In this research paper, we propose a novel approach for reconstructing external nasal defects based on the Facial Mesh Generation Network (FMGen-Net), aiming to enhance the levels of automation and personalization in virtual reconstruction. (2) Methods: We collected data from 400 3D scans of faces with normal morphology and combined the structured 3D face template and the Meshmonk non-rigid registration algorithm to construct a structured 3D facial dataset for training FMGen-Net. Guided by defective facial data, the trained FMGen-Net automatically generated an intact 3D face that was similar to the defective face, and maintained a consistent spatial position. This intact 3D face served as the 3D target reference face (3D-TRF) for nasal defect reconstruction. The reconstructed nasal data were extracted from the 3D-TRF based on the defective area using reverse engineering software. The '3D surface deviation' between the reconstructed nose and the original nose was calculated to evaluate the effect of 3D morphological restoration of the nasal defects. (3) Results: In the simulation experiment of 20 cases involving full nasal defect reconstruction, the '3D surface deviation' between the reconstructed nasal data and the original nasal data was 1.45 ± 0.24 mm. The reconstructed nasal data, constructed from the personalized 3D-TRF, accurately reconstructed the anatomical morphology of nasal defects. (4) Conclusions: This paper proposes a novel method for the virtual reconstruction of external nasal defects based on the FMGen-Net model, achieving the automated and personalized construction of the 3D-TRF and preliminarily demonstrating promising clinical application potential.

Nonlinear Ultrasonic C-Scan Imaging for Contact-Type Defects in Diffusion-Bonded Joints-A Case Study.

Diffusion bonding technology is widely used in the connection of precision components, yet accurately and reliably detecting contact-type defects on the bond interface still remains a significant problem. Nonlinear ultrasonic methods have been proven to be sensitive to contact-type defects; however, the use of continuous wave or tone burst wave excitation limits its wider application. In this paper, dual-probe nonlinear ultrasonic testing with pulse wave excitation is proposed to detect contact-type defects in diffusion-bonded joints. A titanium alloy diffusion-bonded specimen with artificial defects was fabricated, and the corresponding detection device was designed based on the existing ultrasonic C-scan testing system. A C-scan imaging program based on nonlinear parameters was developed by extracting the fundamental and second harmonic waves of the reflection echo on the bond interface. The results demonstrated that the proposed detection scheme can obtain the nonlinear parameters of diffusion-bonded interfaces, and the nonlinear ultrasonic C-scan image of the bond interface is also obtained. The nonlinear parameter in the contact-type defects areas calculated from the bond interface echo is about 10 times (20 dB) higher than that in macro defects areas, whose gap is about 10 μm. The results indicate that the nonlinear ultrasonic methods seem to be more sensitive to contact-type defects and have a great potential to complement the insufficient detection capability of linear ultrasound for diffusion-bonded joints.

Matrix Metalloproteinase-Responsive Hydrogel with On-Demand Release of Phosphatidylserine Promotes Bone Regeneration Through Immunomodulation.

Inflammation-responsive hydrogels loaded with therapeutic factors are effective biomaterials for bone tissue engineering and regenerative medicine. In this study, a matrix metalloproteinase (MMP)-responsive injectable hydrogel is constructed by integrating an MMP-cleavable peptide (pp) into a covalent tetra-armed poly-(ethylene glycol) (PEG) network for precise drug release upon inflammation stimulation. To establish a pro-regenerative environment, phosphatidylserine (PS) is encapsulated into a scaffold to form the PEG-pp-PS network, which could be triggered by MMP to release a large amount of PS during the early stage of inflammation and retain drug release persistently until the later stage of bone repair. The hydrogel is found to be mechanically and biologically adaptable to the complex bone defect area. In vivo and in vitro studies further demonstrated the ability of PEG-pp-PS to transform macrophages into the anti-inflammatory M2 phenotype and promote osteogenic differentiation, thus, resulting in new bone regeneration. Therefore, this study provides a facile, safe, and promising cell-free strategy on simultaneous immunoregulation and osteoinduction in bone engineering.

Application of V-Y advancement flap with facial artery perforator for the repair of midface skin defects

Objective: To investigate the efficacy of V-Y advancement flap with facial artery perforator for the repair of midface skin defects. Methods: A retrospective analysis was performed on 18 patients with facial skin cancer, including 11 males and 7 females, aged 65-83 years, who underwent the repair of midface skin defects using V-Y advancement flap with facial artery perforator in the Department of Head and Neck Surgery, Affiliated Cancer Hospital of Nantong University from January 2020 to April 2023. Medium, large or complex midface skin defects developed after surgical resections of the primary lesions. According to the defect site, size, location information of facial vessels, a V-Y advancement flap with appropriate shape was designed for each case. During the operation, the facial vessels and their perforators were retained in the pedicle of the flap, the facial nerve branches were dissected and protected, and the further denuded pedicle was determined according to actual amount of advancement. After the flap was advanced, the facial defect area was repaired without tension, and the anatomical positions and functions of the eyes, nose and mouth were restored as far as possible. Postoperative follow-ups were conducted to observe the survival rate of the flaps, postoperative complications, recurrences and metastases of tumors. Results: Midface defects of 3.0 cm×3.5 cm-6.5 cm×7.5 cm were observed after tumor resections, which involved one or more subregions. The sizes of the flaps were 3.5 cm×9.0 cm-7.0 cm×18.0 cm. All flaps were completely alive except for one with temporary local bruising. With following-up of 4-40 months, 5 of the 12 patients with lower eyelid and inner canthus invasions had lower eyelid ectropion, but no exposed keratitis was found; one case with poorly differentiated squamous cell carcinoma had lymph node metastasis in the submandibular region and underwent neck dissection again; no recurrence or metastasis occurred in the remaining cases. Conclusion: The V-Y advancement flap with facial artery perforator can be used to repair medium, large or complex midface skin defects, with a high survival rate, and the operation method is safe and reliable.

Quantification of depth and morphology of internal corrosion defects by stepped eddy current thermography skewness under weak excitation conditions

In the nondestructive testing (NDT) of eddy current thermography of oil and gas tanks, the low and non-uniform temperature rise due to weak excitation conditions makes the quantitative estimation of the depth and area of defects still challenging. This work proposes a mathematical-physical model of skewness to characterize defect depth quantitatively. The skewness image is estimated in Gaussian scale space using the background difference method combined with the chunked threshold segmentation method to characterize the defect morphology. The experimental results show that the skewness is affected by the combination of defect depth and area. As the defect area decreases, the relationship between defect depth and skewness gradually degrades from nonlinear to linear, while the rate of change of skewness becomes insignificant. The skewness analysis model predicted the maximum MRE of 5.15%, the minimum R2 of 0.94 for defect depth, and the MRE of 8.39% for defect area. It shows that the skewness can effectively characterize the depth and morphology of internal corrosion defects.

ПРИМЕНЕНИЕ СИНТЕТИЧЕСКОГО ИМПЛАНТАТА НА ОСНОВЕ ГИДРОКСИАПАТИТА И ВОЛЛАСТОНИТА ДЛЯ СТИМУЛЯЦИИ ПРОЦЕССОВ РЕГЕНЕРАЦИИ КОСТНОЙ ТКАНИ

The aim of the study is to evaluate the efficiency of using bone substitute material grounded on hydro-xyapatite and wollastonite based on changing clinical status indicators, radiographic examination and hematological parameters. A preclinical study was conducted at the Faculty of Veterinary Medicine, Institute of Veterinary Medicine and Biomedical Sciences, Omsk State Agrarian University named after P.A. Stolypin. The object of the study was laboratory rabbits (n = 10) of the white New Zealand breed, HYCOLE genetics, aged (13 ± 1.2) months, weighing (4.78 ± 0.37) kg with a formed model of cortical bone defect of the femur in the distal metaphysis area. To evaluate the efficiency, the animals were divi-ded into 2 groups. Animals for the study were selected using the analog method. In animals from group I, the defect cavity was closed with SiHA granules. Group II remained intact without replenishment of the cortical defect. The dynamics of reparative processes were monitored using clinical, biochemical and ra-diological studies. At all stages of observation, animals of group I were distinguished by relatively fast hea-ling times and restoration of physiological indicators and support on the operated limb. X-ray examination showed tight contact of bone tissue with the SiHA and formation of bone intermedial callus in the defect area. According to the hematological study, an increase in the indicators of biochemical markers of osteogenesis in animals with replenishment of the bone defect of the SiHA was monitored, which indicates active regeneration processes. The data obtained give reason to assume the effectiveness of using the SiHA to stimulate reparative regeneration in animals with bone pathologies.

Study on the method of evaluating the failure of stator bar insulation materials based on mechanical damage characteristics

The damage impact of mechanical shocks on stator bar insulation is a key factor in high-voltage motor accidents. This study conducted electrical aging acceleration and breakdown experiments on damaged stator insulating materials to understand failure causes and evaluation methods. The relationship between sample defect area and depth and electrical properties was analyzed, along with the morphology of the damaged surface using a scanning electron microscope. Results show that the defect area correlates with impact mode but does not directly impact electrical performance. Effective insulation thickness is positively linked to electrical performance. This study serves as a valuable reference for evaluating mechanical impact faults in high-voltage motors.

Correlation Between Volume and Pressure of Intracranial Space With Craniectomy Surface Area and Brain Herniation: A Phantom-Based Study.

There are proponents of decompressive craniectomy (DC) and its various modifications who claim reasonable clinical outcomes for each of them. Clinical outcome in cases of traumatic brain injury, managed conservatively or aided by different surgical techniques, depends on multiple factors, which vary widely among patients and have complex interplay, making it difficult to compare one case with another in absolute terms. This forms the basis of the perceived necessity to have a standard model to study, compare, and strategize in this field. We designed a phantom-based model and present the findings of the study aimed at establishing a correlation of the volume of intracranial space and changes in intracranial pressure (ICP) with surface area of the craniectomy defect created during DC and brain herniation volume. A roughly hemispherical radio-opaque container was scanned on a 128-slice computed tomography scanner. Craniectomies of different sizes and shapes were marked on the walls of the phantom. Two spherical sacs of stretchable materials were subsequently placed inside the phantom, fixed to three-way connectors, filled with water, and connected with transducers. The terminals of the transducer cables were coupled with the display monitor through a signal amplifier and processor module. Parts of the wall of the phantom were removed to let portions of the sac herniate through the defect, simulating a DC. Volume measurements using AW volume share 7® software were done. Resection of a 12.7 × 11.5 cm part of the wall resulted in a 10-cm-diameter defect in the wall. Volume differential of 35 mL created a midline shift of 5 mm to the side with lesser volume. When measuring pressure in two stretchable sacs contained inside the phantom, there always remained a pressure differential ranging from 1 to 2 mm Hg in different recordings, even with sacs on both sides containing an equal volume of fluids. Creating a circular wall defect of 10 cm in diameter with an intracavitary pressure of 35 mm Hg on the ipsilateral sac and 33 mm on the contralateral sac recorded with intact walls, resulted in a true volume expansion of 48.411 cm3. The herniation resulted in a reduction of pressure in both sacs, with the pressure recorded as 25 mm in the ipsilateral sac and 24 mm in the contralateral sac. The findings closely matched those of the other model-based studies. Refinement of the materials used is likely to provide a valid platform to study cranial volume, ICP, craniectomy size, and brain prolapse volume in real time. The model will help in pre-operatively choosing the most appropriate technique between a classical DC, a hinge craniotomy, and an expansive cranioplasty technique in cases of refractory raised ICP.

Ultimate flexural strength and Young’s modulus analysis of denture base resins for masked stereolithography 3D printing technology

of the study is to investigate the ultimate flexural strength and Young’s modulus of some materials, which can be used for complete denture fabrication by Masked stereolithography 3D printing technology.Three groups of five specimens each were fabricated. Two of the groups are 3D printed by Masked SLA 3D printer of two commonly used denture base resins. The third group is set to be a control as the specimens were fabricated of a heat-curing acrylic resin. A three-point flexural test tested the objects, and the data collected was used to determine ultimate flexural strength and Young’s modulus calculation. All the results are compared to the ISO Standard 20795-1.The data shows that the mean ultimate flexural strength of the 3D printed specimens is 87 MPa - 89 MPa. Their results are very similar to those for the heat-curing acrylic resin, which means the ultimate flexural strength is 93 MPa. The mean Young’s modulus obtained for the first group of 3D printed specimens is 2263.21 MPa and 2377.44 MPa for the second one. As for the control group, 2396.06 MPa is achieved. When ISO Standard 20795-1 is inspected, all the data obtained covers the minimum requirements.The limitations of the study concern to some additional factors that should be observed for more detailed evaluation. For example, the level of the final polymerization of light-curing resins for 3D printing, their ability to washstand to different defect and denture-bearing area characteristics (the notch for the labial and buccal frenulum, chambers for torus release, etc.), the ability of the materials to withstand to cyclic load, etc.3D printing is faster and cheaper than conventional methods for complete denture fabrication. The knowledge about the mechanical properties of the different materials for 3D printing is very valuable for properly selecting a material and approach for complete denture fabrication.Nowadays, 3D printing is essential in dentistry. For this reason, observation and knowledge of the raw materials properties is very important for the proper choice of a material and/or technology for each clinical case.

Macrophage membrane (MMs) camouflaged near-infrared (NIR) responsive bone defect area targeting nanocarrier delivery system (BTNDS) for rapid repair: promoting osteogenesis via phototherapy and modulating immunity

Bone defects remain a significant challenge in clinical orthopedics, but no targeted medication can solve these problems. Inspired by inflammatory targeting properties of macrophages, inflammatory microenvironment of bone defects was exploited to develop a multifunctional nanocarrier capable of targeting bone defects and promoting bone regeneration. The avidin-modified black phosphorus nanosheets (BP-Avidin, BPAvi) were combined with biotin-modified Icaritin (ICT-Biotin, ICTBio) to synthesize Icaritin (ICT)-loaded black phosphorus nanosheets (BPICT). BPICT was then coated with macrophage membranes (MMs) to obtain MMs-camouflaged BPICT (M@BPICT). Herein, MMs allowed BPICT to target bone defects area, and BPICT accelerated the release of phosphate ions (PO43−) and ICT when exposed to NIR irradiation. PO43− recruited calcium ions (Ca2+) from the microenvironment to produce Ca3(PO4)2, and ICT increased the expression of osteogenesis-related proteins. Additionally, M@BPICT can decrease M1 polarization of macrophage and expression of pro-inflammatory factors to promote osteogenesis. According to the results, M@BPICT provided bone growth factor and bone repair material, modulated inflammatory microenvironment, and activated osteogenesis-related signaling pathways to promote bone regeneration. PTT could significantly enhance these effects. This strategy not only offers a solution to the challenging problem of drug-targeted delivery in bone defects but also expands the biomedical applications of MMs-camouflaged nanocarriers.Graphical

In vivo research on 3D-printed composite PLGA and PDLLA-HA absorbable scaffolds for repairing radius defects in rabbits.

Despite being an important research topic in oral biomaterials, few studies have demonstrated the differences between poly(d,l-lactide-co-glycolide)/hydroxyapatite (PLGA/HA) and poly(d,l-lactic acid)/hydroxyapatite (PDLLA/HA). In this study, PLGA/HA and PDLLA/HA scaffolds were prepared using three-dimensional (3D) printing technology and implanted into radius defects in rabbits to assess their effects on bone regeneration. In this study, 6 mm × 4 mm bone defects were generated in the bilateral radii of rabbits. 3D-printed PLGA/HA and PDLLA/HA scaffolds were implanted into the defects. X-ray imaging, micro-computed tomography, and hematoxylin-eosin staining were performed to observe the degradation of the materials, the presence of new bone, and bone remodeling in the bone defect area. The PLGA/HA scaffolds displayed complete degradation at 20 weeks, whereas PDLLA/HA scaffolds exhibited incomplete degradation. Active osteoblasts were detected in both groups. The formation of new bone, bone marrow cavity reconstruction, and cortical bone remodeling were better in the PLGA/HA group than in the PDLLA/HA group. PLGA/HA scaffolds performed better than PDLLA/HA scaffolds in repairing bone defects, making the former scaffolds more suitable as bone substitutes at the same high molecular weight.

Comprehensive functional outcome analysis and importance of bone remodelling on personalized cranioplasty treatment using Poly(methyl methacrylate) bone flaps.

Cranioplasty involves the surgical reconstruction of cranial defects arising as a result of various factors, including decompressive craniectomy, cranial malformations, and brain injury due to road traffic accidents. Most of the modern decompressive craniectomies (DC) warrant a future cranioplasty surgery within 6-36months. The conventional process of capturing the defect impression and polymethyl methacrylate (PMMA) flap fabrication results in a misfit or misalignment at the site of implantation. Equally, the intra-operative graft preparation is arduous and can result in a longer surgical time, which may compromise the functional and aesthetic outcomes. As part of a multicentric pilot clinical study, we recently conducted a cohort study on ten human subjects during 2019-2022, following the human ethics committee approvals from the participating institutes. In the current study, an important aspect of measuring the extent of bone remodelling during the time gap between decompressive craniectomy and cranioplasty was successfully evaluated. The sterilised PMMA bone flaps were implanted at the defect area during the cranioplasty surgery using titanium mini plates and screws. The mean surgery time was 90 ± 20min, comparable to the other clinical studies on cranioplasty. No signs of intra-operative and post-operative complications, such as cerebrospinal fluid leakage, hematoma, or local and systemic infection, were clinically recorded. Importantly, aesthetic outcomes were excellent for all the patients, except in a few clinical cases, wherein the PMMA bone flap was to be carefully customized due to the remodelling of the native skull bone. The extent of physiological remodelling was evaluated by superimposing the pre-operative and post-operative CT scan data after converting the defect morphology into a 3D model. This study further establishes the safety and efficacy of a technologically better approach to fabricate patient-specific acrylic bone flaps with improved surgical outcomes. More importantly, the study outcome further demonstrates the strategy to address bone remodelling during the patient-specific implant design.

Comparative evaluation of treatment of angular bone defect related to over-erupted tooth using guided tissue regeneration (GTR) followed by orthodontic intrusion (OI) versus OI followed by GTR: a controlled clinical trial

BackgroundPrematurity resulted from pathological migration of periodontally involved teeth with the loss of vertical stopping points between teeth, which can lead to teeth over eruption with dimensional changes favoring occlusal discrepancies. Therefore, evaluating and comparing the effect of guided tissue regeneration followed by orthodontic intrusion as opposed to orthodontic intrusion tracked by guided tissue regeneration in the treatment of an over-erupted tooth with angular bone loss.MethodsTwenty teeth in ten cases were selected with at least two teeth with vertical over-eruption and angular bone loss with the presence of their opposing. In group one, ten teeth over-erupted were treated by guided tissue regeneration followed by orthodontic intrusion, whereas, in group two, ten teeth over-erupted were treated by orthodontic intrusion followed by guided tissue regeneration. They were evaluated clinically for pocket depth, bleeding on probing, and tooth mobility. Radiographical evaluation assessed by cone beam computed tomography.ResultsClinically, there existed a statistically significant difference (P value ≤ 0.05) in favor of group one at six months post and in favor of group two at one year from re-evaluation regarding pocket depth and tooth mobility. Radiographically, in group one, there was a statistically significant improvement (P value ≤ 0.05) at six months post-guided tissue regeneration or orthodontic intrusion regarding defect depth and dimensional changes of the defect area, with a statistically significant difference (P value ≤ 0.05) in favor of group two at one year from re-evaluation phase regarding defect depth and defect area dimensional changes.ConclusionThere was a short-term improvement in group one, which deteriorated over a long period compared with group two, so it is preferable to start orthodontic intrusion before guided tissue regeneration.